1/51. The ocular manifestations of congenital infection: a study of the early effect and long-term outcome of maternally transmitted rubella and toxoplasmosis.PURPOSE: To study the spectrum of adverse ocular effects which result from maternally transmitted rubella and toxoplasma infection; further, to record the long-term visual and neurodevelopmental outcomes of these 2 major causes of fetal infection. STUDY DESIGN AND patients: A series of 55 patients with congenital infection have been studied prospectively on a long-term basis. The study group included a cohort of 34 cases with congenital rubella syndrome demonstrated by virus isolation, and 21 cases with a clinical diagnosis of congenital toxoplasmosis and serologic confirmation. All patients had specific disease-related ocular defects. Rubella patients were first identified during or following the last major rubella epidemic in 1963-1964, and some have been followed serially since that time. A separate study group of representative toxoplasmosis patients presented for examination and diagnosis at varying time periods between 1967 and 1991. OBSERVATIONS AND RESULTS: This study confirms that a broad spectrum of fetal injury may result from intrauterine infection and that both persistent and delayed-onset effects may continue or occur as late as 30 years after original infection. Many factors contribute to the varied outcome of prenatal infection, the 2 most important being the presence of maternal immunity during early gestation and the stage of gestation during which fetal exposure occurs in a nonimmune mother. RUBELLA: As a criteria of inclusion, all 34 rubella patients in this study exhibited one or more ocular defects at the time of birth or in the immediate neonatal period. Cataracts were present in 29 (85%) of the 34, of which 21 (63%) were bilateral. Microphthalmia, the next most frequent defect, was present in 28 (82%) of the 34 infants and was bilateral in 22 (65%). glaucoma was recorded in 11 cases (29%) and presented either as a transient occurrence with early cloudy cornea in microphthalmic eyes (4 patients), as the infantile type with progressive buphthalmos (1 patient), or as a later-onset, aphakic glaucoma many months or years following cataract aspiration in 11 eyes of 6 patients. Rubella retinopathy was present in the majority of patients, although an accurate estimate of its incidence or laterality was not possible because of the frequency of cataracts and nystagmus and the difficulty in obtaining adequate fundus examination. toxoplasmosis: Twenty-one patients with congenital toxoplasmosis have been examined and followed for varying time periods, 7 for 20 years or more. The major reason for initial examination was parental awareness of an ocular deviation. Twelve children (57%) presented between the ages of 3 months and 4 years with an initial diagnosis of strabismus, 9 of whom had minor complaints or were diagnosed as part of routine examinations. All cases in this study have had evidence of retinochoroiditis, the primary ocular pathology of congenital toxoplasmosis. Two patients had chronic and recurrent inflammation with progressive vitreal traction bands, retinal detachments, and bilateral blindness. Macular lesions were always associated with central vision loss; however, over a period of years visual acuity gradually improved in several patients. Individuals with more severe ocular involvement were also afflicted with the most extensive central nervous system deficits, which occurred following exposure during the earliest weeks of gestation. CONCLUSIONS: Although congenital infection due to rubella virus has been almost completely eradicated in the united states, the long-term survivors from the prevaccination period continue to experience major complications from their early ocular and cerebral defects. They may be afflicted by the persistence of virus in their affected organs and the development of late manifestations of their congenital infection. Congenital toxoplasmosis continues to be the source of major defects for 3,000 to 4,100 infants in the united states each year; the spectrum of defects is wide and may vary from blindness and severe mental retardation to minor retinochoroidal lesions of little consequence. Effective solutions for either the prevention or treatment of congenital toxoplasmosis have not been developed in this country but are under intensive and continuing investigation.- - - - - - - - - - ranking = 1keywords = virus (Clic here for more details about this article) |
2/51. Persistent fetal rubella vaccine virus infection following inadvertent vaccination during early pregnancy.Inadvertent immunisation of seronegative women with RA27/3 rubella virus live-attenuated vaccine several weeks before and after conception is described. Whereas in 5 cases the vaccine virus was not transmitted vertically, in 1 case vaccination led to the development of persistent fetal infection with prolonged virus shedding for more than 8 months. sequence analysis carried out on isolates from amniotic fluid, from cord blood leukocytes as well as from infantile urine confirmed an infection by the vaccine strain. At birth, the newborn infant exhibited none of the symptoms compatible with the congenital rubella syndrome and signs indicative for development of late onset disease are not apparent. This observation constitutes the first unequivocal documented case of rubella vaccine virus related to persistent fetal infection.- - - - - - - - - - ranking = 2.6666666666667keywords = virus (Clic here for more details about this article) |
3/51. Rubella-associated aplastic anemia treated by syngeneic stem cell transplantations.A 14-year-old boy presented with aplastic anemia 3 months after contracting rubella. Stem cell transplantations from his identical twin were carried out. Successful engraftment occurred only when conditioning therapy was given prior to the infusion of the syngeneic stem cells, supporting an immune mechanism to explain the pathogenesis of virus-associated aplastic anemia.- - - - - - - - - - ranking = 0.33333333333333keywords = virus (Clic here for more details about this article) |
4/51. Virus-associated hemophagocytic syndrome due to rubella virus and varicella-zoster virus dual infection in patient with adult idiopathic thrombocytopenic purpura.A 26-year-old woman with idiopathic thrombocytopenic purpura (ITP) was admitted to our hospital because of fever and rash. blood tests revealed thrombocytopenia, liver dysfunction, coagulopathy, and hyperferritinemia. bone marrow examination revealed many atypical lymphocytes and some histiocytes with hemophagocytosis. On admission she was diagnosed with rubella virus-associated hemophagocytic syndrome (VHAS), but on laboratory examination, she was seropositive for varicella-zoster virus (VZV)-IgM as well as rubella virus-IgM. She was therefore diagnosed with dual infection by rubella virus and VZV. Her simultaneous rubella virus and VZV infection may have been related to the VAHS pathogenesis. She was treated with prednisolone and gamma globulin therapy and recovered completely.- - - - - - - - - - ranking = 4.3333333333333keywords = virus (Clic here for more details about this article) |
5/51. Rubella-associated perimyocarditis--a case report.Perimyocarditis represents an inflammation of both the myocardium and pericardium. Although several causative agents have been recognized, pericarditis or myocarditis associated with rubella is an unusual complication. In a 29-year-old woman, left ventricular function transiently deteriorated accompanied by ongoing cardiac inflammation a few days after illness. The titer of rubella virus increased from seronegative to more than 32-fold during the admission, and a rise in specific antirubella virus antibody was present. The patient was suspected of having perimyocarditis associated with the rubella infection. The authors also present clinical features of rubella-associated perimyocarditis and myocarditis in the literature.- - - - - - - - - - ranking = 0.66666666666667keywords = virus (Clic here for more details about this article) |
6/51. Progressive rubella panencephalitis. Follow-up EEG study of a case.Progressive rubella panencephalitis is a very rare slow virus disease of the nervous system. The authors present a case, concerning a young man, aged 20 years, died 11 months after the onset of the disease. The following peculiarities of the case are emphasized: 1) the clinical symptomatology and the evolution (myoclonus, lack of cerebellar impairment) could suggest the diagnosis of SSPE; 2) the EEG recordings showed epileptiform abnormalities, long latency diffuse periodic complexes and--during interferon therapy and simultaneously with a temporary clinical improvement--the appearance of short latency anterior periodic complexes.- - - - - - - - - - ranking = 0.33333333333333keywords = virus (Clic here for more details about this article) |
7/51. Self-limited colitis during the course of rubella and cytomegalovirus infection in an immunocompetent adult.We report a case of self-limited colitis in cytomegalovirus (CMV) infection in an immunocompetent adult. A 22-year-old man developed a high fever and diarrhea. Laboratory data revealed an increased number of lymphocytes and liver damage. Enzyme immunoassays for anti-virus antibodies revealed that the patient was recently infected with CMV and rubella. colonoscopy revealed severe erosive and edematous mucosa that resembled ulcerative colitis (UC). The symptoms, laboratory data and colonoscopic findings improved without any medical treatment. This case indicates that UC-like self-limited colitis can occur in an immunocompetent individual during the course of CMV infection.- - - - - - - - - - ranking = 2keywords = virus (Clic here for more details about this article) |
8/51. Sequential follow up observations of a patient with rubella associated persistent arthritis.In 1985 a patient was described whose persistent polyarthritis was found to be aetiologically linked to rubella virus infection through the detection of repeated maximal synovial lymphocyte proliferative responses to rubella virus antigen and by isolation of rubella virus from her synovium. Follow up over the succeeding seven years has shown continuing chronic polyarthritis and persistent synovial lymphocyte responses to rubella virus antigen with the additional observation that she has a defective humoral immune response against rubella virus.- - - - - - - - - - ranking = 1.6666666666667keywords = virus (Clic here for more details about this article) |
9/51. A case of holoprosencephaly and cebocephaly associated to torch infection.Cebocephaly is a very rare congenital anomaly combining a severe midline facial malformation and holoprosencephaly. Here we report on first case of cebocephaly with semilobar holoprosencephaly, hypotelorism, and a single nostril due to intrauterine TORCH infection (toxoplasmosis, other [syphilis, varicella-zoster, parvovirus B19], Rubella, cytomegalovirus [CMV], and Herpes infections) in the English language literature. Chromosomal analysis showed normal karyotyping.- - - - - - - - - - ranking = 0.66666666666667keywords = virus (Clic here for more details about this article) |
10/51. Rubella-associated hemophagocytic syndrome in an infant.Hemophagocytic syndrome (HPS) is a fulminant disorder characterized pathologically by multiple-organ infiltration of hemophagocytic histiocytes in the lymphoreticular tissues. The characteristic pathologic feature is reactive histiocytic hyperplasia with leukoerythrophagocytosis in a variety of organs. This disorder occurs most often in patients in whom the immune system is compromised and has been associated with a variety of infectious agents, including viruses, bacteria, mycobacteria, spirochetes, fungi, and parasites. The authors describe a 2.5-month-old girl with rubella-associated HPS, demonstrated by postmortem liver necropsy.- - - - - - - - - - ranking = 0.33333333333333keywords = virus (Clic here for more details about this article) |
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